| Objective To conduct the staging of pneumoconiosis with chest high kv photography combined CT（CT）according to GBZ70-2015 "Diagnosis of Occupational pneumoconiosis",explore the pulmonary dysfunction in different stages,and analyze the influencing factors of pulmonary dysfunction in patients,to provide help for clinical diagnosis and treatment of pneumoconiosis patients.Methods 153 patients with pneumoconiosis in Hefei Occupational Disease Prevention and Control Center were selected,and each patient received chest high kv photography,chest CT and lung function examination within the one day.According to GBZ 70-2015 "Diagnosis of Occupational pneumoconiosis",the chest high kv photography and chest CT imaging manifestations of each patient were comprehensively evaluated,and staging of pneumoconiosis according to the results.To analyze the pulmonary dysfunction of patients with pneumoconiosis at different stages,as well as the differences between patients’ pulmonary dysfunction at different ages,years of dust reception,smoking status,and imaging presentations.Statistically significant influencing factors were screened,and whether lung function abnormality was used as the dependent variable,binary logistic regression analysis was used for risk factor analysis.Results（1）The higher the stage of pneumoconiosis,the higher the rate of abnormal pulmonary function and the higher the pulmonary function classification（G=0.723,P<0.01;rs=0.521,P<0.01）.Obstructive pulmonary dysfunction was most common in the first stage pneumoconiosis patients and the second stage pneumoconiosis patients,while mixed pulmonary dysfunction was most common in the third stage pneumoconiosis patients.（2）There were differences in pulmonary dysfunction among patients with different imaging manifestations,age,working age,and smoking status.Imaging grade was positively correlated with pulmonary function grade and the probability of pulmonary dysfunction（G=0.525,P<0.01;rs =0.437,P <0.01）.The higher the overall density of pneumoconiosis shadows,the more distribution of lung areas,and the more serious the patient’s pulmonary dysfunction.The larger the diameter（or width）of the pneumoconiosis shadow,the higher the probability of pulmonary dysfunction（rs=0.338,P<0.01）.For patients with small shadow clusters and/or large shadows,the pulmonary function classification and the probability of pulmonary dysfunction were higher than in patients with only small shadows.There were differences in the pulmonary function of patients with different small shadow patterns（P < 0.01）,and the effect of small irregular shadows on the lung function of patients with pneumoconiosis was more significant.Pneumoconiosis patients with emphysema had more severe pulmonary dysfunction（P<0.05）.The older the patients with pneumoconiosis,the higher the detection rate of pulmonary dysfunction and the more serious the pulmonary dysfunction（P<0.05）.The longer the years of exposure to pneumoconiosis,the higher the probability of pulmonary function classification and pulmonary dysfunction（P<0.05）.Smoking can aggravate pulmonary dysfunction,and the pulmonary dysfunction of patients with pneumoconiosis who have always smoked and who had quit smoking was more severe than that of patients who have never smoked（P<0.0167）.（3）Binary logistic regression showed that compared with the first stage pneumoconiosis,the OR values of the second stage pneumoconiosis and the third stage pneumoconiosis were 7.201 and 54.747.Compared with the group without emphysema,the OR for the combined emphysema group was 2.806.Compared with patients aged ≤40 years old,the OR values of the 61~70-year-old group,and the >70-year-old group were 7.364 and 13.201 respectively.Compared with the non-smoking group,the OR values of the quit smoking group and the smoking group were 3.110、9.495.Conclusion（1）There are differences in lung function among patients with three stages of pneumoconiosis.As the stage of pneumoconiosis increases,the rate of abnormal lung function increases,the degree of lung dysfunction increases,and the type of lung dysfunction develop from obstructive to mixed.（2）Pneumoconiosis stage,the total density of small shadows in pneumoconiosis,distribution of lung area,size of shadows,the shape of small shadows,emphysema,age,length of exposure to dust,smoking status,and lung function were related to a certain extent.They are influential factors in pulmonary dysfunction.（3）The high pneumoconiosis stage,advanced age,smoking,and combined emphysema are risk factors for lung dysfunction. |
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